"Very long" aortic grafts.

During the past 2 decades, we have been using the so-called "very long" (ascending to infrarenal aorta or ascending aorta to common femoral artery) bypass grafts in selected patients. Our experience with this method includes patients with dissecting as well as arteriosclerotic aneurysms of the descending aorta, thoracoabdominal aneurysms, patients in need of aortic surgery with previous abdominal aortic surgery, radiation treatment, aortic thrombosis, and complex aortic coarctation in the adult. The technique proved to be relatively easy to perform, was well tolerated by most patients and replaced more complicated and higher risk "conventional" operations. The advantages and shortcomings of the method as well as long range clinical observations are presented.